On December 22, 2021, the California Department of Public Health (“CDPH”) amended an existing State Health Order[1] to require that workers at health care facilities[2] who are eligible, receive a COVID-19 vaccine booster no later than February 1, 2022[3] in order to continue working at such facilities.
While this bulletin is intended primarily to inform employers that operate such facilities of the new booster requirement, it is also intended to provide notice to other employers that health orders of this type are likely to become common in non-health care settings where state or local health officers have previously issued vaccination requirements.
Scope of Coverage
The Order covers not only health care workers, but all workers at health care facilities “who have the potential for direct or indirect exposure to patients or SARS-CoV-2 airborne aerosols.” As a result, the Order applies to physicians, nurses, and others who provide direct patient care but also persons not directly involved in such care, but who could be exposed to infectious agents, such as clerical, security, facilities management, administrative, and laundry personnel among others.
COVID-19 Booster Requirement
The Order now requires that workers covered be “fully vaccinated and boosted” for COVID-19. The CDPH provides the following table to show when workers should receive COVID-19 boosters based on the primary vaccination series that the individual received:
| COVID-19 Vaccine | Primary vaccination series | When to get the vaccine booster dose | Which vaccine booster dose to receive |
| Moderna or Pfizer-BioNTech | 1st and 2nd doses | Booster dose six (6) months after 2nd dose | Any of the COVID-19 vaccines authorized in the United States may be used for the booster dose, but either Moderna or Pfizer-BioNTech are preferred. |
| Johnson and Johnson (“J&J”)/Janssen | 1st dose | Booster dose two (2) months after 1st dose | Any of the COVID-19 vaccines authorized in the United States may be used for the booster dose, but either Moderna or Pfizer-BioNTech are preferred. |
| World Health Organization (“WHO”) emergency use listing COVID-19 vaccine | All recommended doses | Booster dose six (6) months after getting all recommended doses | Single booster dose of Pfizer-BioNTech COVID-19 vaccine |
| A mix and match series composed of any combination of FDA-approved, FDA-authorized, or WHO-EUL COVID-19 vaccines | All recommended doses | Booster dose (6) months after getting all recommended doses | Single booster dose of Pfizer-BioNTech COVID-19 vaccine |
Under the updated Order, workers who are currently eligible for booster doses must receive their booster doses no later than February 1, 2022. Workers who are not yet eligible for boosters must receive a booster no later than 15 days after the recommended timeframe for receiving such a booster, as provided above.
Exemptions for Workers with Sincerely Held Religious Beliefs or a Qualifying Medical Reason
The updated Order retains the existing exemption for workers who are unable to be vaccinated due to a sincerely held religious belief or qualifying medical reason. Workers who are exempted, but continue to work in health care facilities, must submit to regular COVID-19 testing and use a face covering while in such facilities.
Liebert Cassidy Whitmore attorneys are familiar with the operation of this and earlier guidance provided by CDPH concerning workers in high-risk congregate settings and are available to assist clients with questions about these orders. We anticipate that state and local agencies will start making such booster shots mandatory in other circumstances where there are requirements concerning vaccination.
[1] The California Department of Public Health (“CDPH”) issued the original version of the State Health Order on August 5, 2021.
[2] The Order defines “health care facilities” to include: (1) General Acute Care Hospitals; (2) Skilled Nursing Facilities (including Subacute Facilities); (3) Intermediate Care Facilities; (4) Acute Psychiatric Hospitals; (5) Adult Day Health Care Centers; (6) Program of All-Inclusive Care for the Elderly (PACE) and PACE Centers; (7) Ambulatory Surgery Centers; (8) Chemical Dependency Recovery Hospitals; (9) Clinics & Doctor Offices (including behavioral health, surgical); (10) Congregate Living Health Facilities; (11) Dialysis Centers; (12) Hospice Facilities; (13) Pediatric Day Health and Respite Care Facilities; and (14) Residential Substance Use Treatment and Mental Health Treatment Facilities.
[3] Workers who are not yet eligible for boosters must receive a booster no later than 15 days after the recommended timeframe for receiving such a booster, as provided above.